Chantelle Brielle Young Adaba, MD, MS

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

848 Candlebark Dr
Jacksonville, FL 32225-5322

Phone

(404) 934-0077

NPI assigned

May 25, 2018

Last updated

Jul 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Dr. Chantelle Brielle Young Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1295226249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAYPORT NAVAL BASE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 CANDLEBARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255322",
            "telephone_number": "404-934-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADABA",
        "first_name": "CHANTELLE",
        "middle_name": "BRIELLE YOUNG",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2024-07-05",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANTELLE",
            "last_name": "YOUNG",
            "middle_name": "BRIELLE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Military Health Care Provider in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Military Health Care Provider in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.